Cortider

• Inflammatory and Allergic Disorders
• Corticosteroid-responsive dermatoses, including eczema, dermatitis, and psoriasis
• Severe allergic reactions affecting skin and mucous membranes
• Endocrine Disorders
• Adrenal insufficiency (as part of replacement therapy)
• Congenital adrenal hyperplasia
• Rheumatologic and Connective Tissue Disorders
• Systemic lupus erythematosus, rheumatoid arthritis flares (short-term management)
• Other Uses
• Post-surgical or post-traumatic inflammation
• Off-label use for certain ophthalmic, otic, or topical inflammatory conditions under professional supervision

• Oral / Systemic Administration
• Adults: 20–240 mg/day, divided doses depending on disease severity
• Pediatrics: 0.5–3 mg/kg/day, divided into 2–4 doses
• Adjust dose according to patient response and clinical condition
• Topical Administration
• Apply a thin layer 1–3 times daily to affected skin
• Limit duration to 7–14 days for localized skin lesions unless directed
• Injection / IM
• For acute adrenal insufficiency or severe inflammation: dose individualized
• Special Populations
• Reduce dose in hepatic or renal impairment
• Taper dose gradually in chronic therapy to avoid adrenal suppression

Hydrocortisone acetate is a glucocorticoid prodrug that is enzymatically converted to active hydrocortisone. It binds to cytoplasmic glucocorticoid receptors, translocating to the nucleus where it modulates gene transcription. This suppresses pro-inflammatory cytokines, inhibits leukocyte migration, stabilizes lysosomal membranes, and reduces capillary permeability. These actions collectively decrease inflammation, immune response, and edema, while providing hormonal replacement in adrenal insufficiency.

• Absorption: Rapid gastrointestinal absorption for oral forms; topical absorption minimal unless applied over damaged skin
• Distribution: Widely distributed in body tissues; crosses placenta and blood-brain barrier
• Metabolism: Primarily hepatic via CYP3A4 enzymes to inactive metabolites
• Elimination: Renal excretion of metabolites; minor fecal excretion
• Half-life: Plasma half-life ~1.5–2 hours; biologic effects last 8–12 hours
• Onset: Hours for systemic effect; topical effect within hours depending on inflammation severity

• Pregnancy: Category C; may be used if benefits outweigh risks
• Lactation: Excreted in small amounts in breast milk; caution advised, especially for long-term or high-dose therapy
• Monitor infants for adrenal suppression or growth effects

• Primary therapeutic class: Corticosteroid
• Subclass: Glucocorticoid, short-acting

• Known hypersensitivity to hydrocortisone or any excipients
• Systemic fungal infections unless combined with antifungal therapy
• Untreated tuberculosis affecting lungs or meninges
• Severe infections without concomitant antimicrobial therapy

• High-risk groups: Pediatric, elderly, pregnant, or immunocompromised patients
• Systemic effects: May cause adrenal suppression, hyperglycemia, hypertension, or osteoporosis with prolonged use
• Infections: Can mask or exacerbate infections; monitor closely
• Tapering: Avoid abrupt discontinuation after long-term therapy to prevent adrenal crisis
• Monitoring: Blood pressure, blood glucose, electrolyte balance, bone density, and signs of infection

• Common: Weight gain, mild fluid retention, facial rounding, mood changes
• Dermatologic (topical): Skin thinning, striae, acne, hypertrichosis
• Gastrointestinal: Peptic ulcers with systemic therapy
• Metabolic: Hyperglycemia, sodium retention, hypokalemia
• Rare/Serious: Adrenal suppression, Cushingoid features, immunosuppression, glaucoma (ocular use), growth suppression in children

• CYP3A4 inhibitors (e.g., ketoconazole): May increase hydrocortisone levels
• CYP3A4 inducers (e.g., rifampicin): May reduce efficacy
• Diuretics: Risk of hypokalemia
• NSAIDs: Increased risk of gastrointestinal ulcers or bleeding
• Vaccines: Live vaccines may have reduced effectiveness or increased risk of infection

• Emphasis on lowest effective dose for shortest duration
• Updated recommendations for monitoring long-term therapy in pediatric and elderly patients
• Guidelines suggest combination therapy with mineralocorticoids in adrenal insufficiency for optimal electrolyte control
• Updated labeling highlights risk of systemic absorption from topical formulations over large areas or broken skin

• Store at 20°C to 25°C (room temperature)
• Protect from light, moisture, and freezing
• Keep in a tightly closed container
• Topical forms: do not use if discolored, separated, or expired
• Injectable forms: protect from extreme temperatures; follow reconstitution instructions if applicable